Preventing Amputation: a Doctor’s Guide for Diabetes Patients

From blackpressusa.com

Amputation is often a last resort for diabetes patients facing severe infections or poor circulation. However, Dr. Estelle Everett, an endocrinologist at UCLA, states that most diabetes-related amputations are preventable through early intervention, consistent medical care, and patient education 

For many diabetes patients, amputation becomes a last-resort measure after infections, ulcers, or poor circulation worsen rapidly and leave few other treatment options.

But according to Dr. Estelle Everett, a physician and researcher specializing in endocrinology, diabetes, and metabolism at the University of California, Los Angeles (UCLA), most diabetes-related amputations can be prevented through early intervention, consistent medical care, and patient education.

For Everett, her commitment to diabetes prevention is deeply personal. Watching her younger sister navigate Type 1 diabetes exposed her early to the challenges many patients face, including barriers to advanced diabetes technologies such as continuous glucose monitors and insulin pumps due to racial disparities in patient care.

Those experiences helped shape her focus on prevention, education, and equitable access to care.

Dr. Everett spoke with California Black Media (CBM) about the warning signs of diabetic complications, prevention strategies, healthcare access, and the role of diabetes technology in improving outcomes.

                                                                                                Photo courtesy UCLA Health

What are some of the early warning signs that a person with diabetes may be developing circulation and nerve problems that could potentially lead to amputation?

Amputation is usually the final stage of diabetic foot disease. Earlier signs often involve nerve damage. Some people experience numbness, tingling, burning, or loss of sensation in their feet.

Poor circulation is another warning sign. Symptoms can include calf pain with walking, foot pain at rest, cold feet, changes in skin color, or wounds that do not heal properly. Foot ulcers, thick calluses, and untreated cuts can also lead to serious infections that may eventually require amputation if not treated early.

Before complications reach that stage, what are some early signs of diabetes that people should look out for?

Many people are walking around with diabetes and do not even realize it. Some patients first seek medical care only after they’ve already developed complications because they’ve had diabetes for years without knowing it.

That’s why routine screenings are so important. If you have diabetes, controlling it early can significantly reduce the risk of severe complications later on.

Many Black Californians harbor a degree of distrust in the healthcare system. What message would you send to encourage people to get regular checkups?

Distrust is real, and there are many reasons people may avoid healthcare. Some fear discrimination or worry they’ll simply be judged instead of helped.

Personally, I realized some of the care my sister received may have been influenced by racial bias. Although she had diabetes for years, she was never offered diabetes technology like insulin pumps or continuous glucose monitors. When she finally asked about them, she was told she had to jump through many hoops.

Later, I realized her experience wasn’t unique. Research shows that minority patients and people from lower-income backgrounds are less likely to be offered diabetes technology. That inspired me to focus my research on improving access for the populations that need these tools the most.

I think building trust is important. Finding the right doctor is almost like dating. If you don’t feel comfortable with your provider, it may help to find someone you connect with and feel understands your concerns. That relationship can make a major difference in getting consistent care.

Are there newer technologies or innovations in diabetes care that people should know about?

One of the biggest advances has been continuous glucose monitors, or CGMs. These small wearable devices track blood sugar levels in real time and have really changed diabetes care over the past decade.

For providers, CGMs give a much clearer picture of blood sugar patterns throughout the day. For patients, they provide immediate feedback about how food, exercise, and other daily habits affect blood sugar levels.

Someone may notice that certain foods cause major spikes while certain exercises lower their blood sugar. That real-time information helps people make healthier decisions and improve blood sugar control. Research shows these technologies can significantly improve outcomes.

What daily habits or preventative measures can reduce the risk of complications or even amputation?

The biggest thing is controlling your diabetes. A lot of people automatically think diabetes will lead to amputations, but research shows the risk is much lower when diabetes is well managed.

That means taking medications as prescribed, making dietary changes, and working to keep your A1C below 7. Managing high blood pressure and high cholesterol is also important because both contribute to circulation problems.

People should also inspect their feet every day, especially if they’ve already lost sensation. Some patients injure their feet without realizing it because they can’t feel the damage. Catching wounds early is critical. Good foot hygiene also plays a major role in prevention.

Are there any common misconceptions about diabetes that stand out to you in your clinical work with Black patients?

One major misconception is that diabetes medications cause complications like kidney failure or amputations. In reality, poorly controlled diabetes causes those complications — not the medications used to treat it.

Those misconceptions sometimes cause patients to avoid medications or stop taking them altogether. Another issue is that some people believe diet and exercise alone should always control diabetes. While lifestyle changes are important, some patients have severe diabetes that also requires medication.

Needing medication is not a personal failure. Sometimes diet and exercise alone are simply not enough, and medication is necessary to prevent serious complications.

This article is supported by the California Health Care Foundation(CHCF). Visit www.chcf.org

Based on reporting by San Diego Voice & Viewpoint.

https://blackpressusa.com/preventing-amputation-a-doctors-guide-for-diabetes-patients/

Type 1 vs. type 2 diabetes: What’s the difference and why does it matter?

From live5news.com

One in eight Americans has diabetes, according to the Centers for Disease Control and Prevention, or CDC, but experts say treatment is not one size fits all. Even when two people share similar symptoms, their diagnoses and care plans can be very different.

Two diseases, one name

Dr. Anna Bradley, an endocrinologist at Vanderbilt University, said both type 1 and type 2 diabetes affect how the body turns food into energy, resulting in blood sugar that is too high. But the reason that happens is not the same.

“In type 1 diabetes, the blood sugar is too high because the pancreas stops producing insulin, and insulin is the hormone that causes the cells of our body to take in glucose or nutrition. So, without that hormone, insulin, our bodies can’t bring sugar from the bloodstream into the cells, where it’s mobilized and used to make energy,” Bradley said.

In type 2 diabetes, the pancreas still produces insulin, but cells become resistant to its signals and stop converting sugar to energy, Bradley said. The pancreas then works in overdrive to compensate, producing excess insulin.

Bradley said that in some long-term type 2 patients, the pancreas eventually gives out, requiring insulin treatment as well.

Treatment depends on type

Because the underlying causes differ, so do the treatments.

Bradley said people with type 1 diabetes must take insulin because their bodies do not produce it. For type 2 patients, she said there are multiple medications available as a first line of defence to help cells respond better to insulin.

The CDC reports that 90 to 95% of people with diabetes have type 2.

Bradley said being overweight is a major risk factor because fat tissue is insulin resistant, and that lifestyle changes, including improved diet and increased physical activity, can, in some cases, reverse the condition.

Warning signs and early detection

Dr. Rhea Rogers, a board-certified physician, said insulin resistance can precede a diabetes diagnosis by 10 to 15 years.

During that window, standard tests such as haemoglobin A1c, may appear normal, even as fasting insulin levels are elevated — a sign the disease process is already underway, Rogers said.

Common symptoms of undiagnosed diabetes include excessive thirst, frequent urination at night and vision changes, Rogers said.

https://www.live5news.com/2026/07/09/type-1-vs-type-2-diabetes-whats-difference-why-does-it-matter/

Recipe: Sweet potato and corn chowder

From diabetes.org.uk

A quick and easy chowder ready in just over half an hour, and bringing together the delicious flavours of sweet potato and sweetcorn, with a little chilli kick, all in one pot. This recipe was selected in partnership with Slimming World

Serves 4     Cook 35 minutes

Ingredients

• Low-calorie cooking spray
• 1 onion, finely chopped
• 1 celery stick, finely chopped
• 2 leeks, finely sliced
• 2 garlic cloves, crushed
• 2 sprigs of fresh thyme, leaves picked
• ¼ tsp dried chilli flakes
• 2 medium sweet potatoes (around 500g), chopped into 1cm cubes
• 1 litre low salt vegetable stock
• 225g frozen sweetcorn, defrosted and warmed through
• Juice of ½ lemon
• 2 tbsp fat-free unsweetened natural Greek yoghurt, to serve
• Pinch of smoked paprika, to serve
• ½ small pack fresh chives, chopped, to serve

• 
  

• Method

  Step 1

  Preheat your oven to 200°C/fan 180°C/gas 6.

  Step 2

  Spray a large non-stick saucepan with a couple of pumps of low-calorie cooking spray and put it over a medium heat. Add the onion, celery, leeks, garlic, thyme, chilli flakes and sweet potatoes. Fry for 6-8 minutes, until softened. Add the stock, bring to boil and simmer for 10-15 minutes, until all the vegetables are really tender.

  Step 3

  Add half the sweetcorn, bring back to a simmer, then blitz with a stick blender until completely smooth. Add the lemon juice and season with pepper

  Step 4

  Divide the chowder between 4 bowls. Drizzle over the yoghurt, scatter with the remaining sweetcorn and sprinkle over the paprika and chives. Serve steaming hot.

  Recipe tips

  You can use a plain yoghurt of your choice. However, this will change the nutritional information and the texture of the dish. 

• https://www.diabetes.org.uk/living-with-diabetes/eating/recipes/sweet-potato-and-corn-chowder?utm_campaign=7199143_Enewsletter%20-%20July%202026%20-%20General&utm_medium=email&utm_source=dot_digital&dm_i=79RZ,4AAW7,1PBE5R,BB7GM,1,0,0,0

Type 2 diabetes over time: What to expect as you age

From mcpress.mayoclinic.org

By Jessica R. Wilson, M.D.

Type 2 diabetes is one of the most common chronic conditions in the U.S. The way it affects each person, however, often varies substantially.

If you have type 2 diabetes, your age and the length of time since you were diagnosed are two major factors likely to influence your condition. Understanding these factors and anticipating changes can help you and your care team create a diabetes management plan that offers you ideal support now and for years to come.

How insulin production and insulin resistance change over time

When you eat food, your body breaks it down into a type of sugar called glucose. Glucose is fuel for your body’s cells. It enters your blood and gets into your cells with help from a naturally occurring hormone called insulin.

All forms of diabetes stem from an insulin issue. If you have type 2 diabetes, your body either doesn’t make enough insulin, can’t use insulin effectively or both. This causes glucose to build up in your blood. If your blood glucose level is too high, too often, it can cause issues throughout your body.

Your amount of insulin and its effectiveness tend to change over time. “It’s a supply and demand issue,” says Jessica R. Wilson, M.D., M.S., an endocrinologist and diabetes expert at Mayo Clinic in Jacksonville, Florida.

When you’re first diagnosed with type 2 diabetes, your pancreas — a vital organ in your abdomen — is typically able to produce insulin. However, the amount produced isn’t enough to match the demand. Type 2 diabetes also makes your cells less sensitive to insulin — a phenomenon known as insulin resistance. This means that more of the hormone is required to move sugar from your bloodstream into your cells.

Insulin resistance pushes the pancreas to produce more insulin. For some people, the pancreas is able to keep up with high demand. For others, it might not. Pancreas damage and age both can lower insulin production, says Dr. Wilson.

To address insulin supply and demand issues, people who have type 2 diabetes often take a medicine designed to lower their demand for insulin. If this isn’t enough to balance supply and demand or if their insulin production drops over time, extra insulin might be needed. This is known as insulin therapy.

Rarely will a person who has diabetes use the same treatment for a lifetime. Certain medicines may become less effective after a while. Switching to a different therapy could make it easier to manage blood glucose. Other factors such as diet and exercise might lower blood glucose and eliminate the need for one or more medicines.

The risk of type 2 diabetes complications can increase over time

Most people who have type 2 diabetes have an elevated risk of complications. Because blood flows throughout the entire body, the impacts of high blood glucose levels can affect many organs and structures. Common type 2 diabetes complications include issues in the heart, kidneys, nerves, eyes and feet.

Effective diabetes management can reduce these risks. Research shows that people with sustained high blood glucose have an elevated risk of developing a complication within the next 10 years. In comparison, people with blood glucose levels that are within the diabetic range, but are near the low end of that range, are less likely to develop a complication within the next 10 years.

Still, any level of sustained elevated blood glucose, including living with a blood glucose level in the prediabetes range, can increase the risk of complications. In addition, the risk of developing complications may be further elevated if you’re an older adult.

Regardless of your age or how long you’ve had diabetes, it’s important to monitor more than just your blood glucose. According to Dr. Wilson, you should start routine screenings for common complications immediately after you’ve been diagnosed with type 2 diabetes. This testing helps your care team identify and address any issues early on.

Why early type 2 diabetes treatment matters

Starting a diabetes management plan immediately after you’re diagnosed can limit the amount of time your blood glucose is too high. Additionally, some research suggests that treating type 2 diabetes early and intensively can create a “legacy effect.” By quickly lowering your blood glucose level with lifestyle changes, medications or other methods, you may have a lower long-term risk of complications, even if your level rises in the future.

Some diabetes treatments are more effective for people with a recent diabetes diagnosis. Metformin is a common diabetes medicine that lowers blood glucose in part by improving insulin sensitivity in the body’s cells. Research suggests that beginning treatment with metformin in the early stages of diabetes — before insulin production may have declined substantially — can lower blood glucose more effectively than starting the medicine later on.

How age influences type 2 diabetes management

Several factors influence how diabetes may affect you. Ethnicity, sex, genetics and other traits all play a part in the condition and are worth considering when planning your diabetes management strategy.

Age is one of the most influential factors in diabetes management. As part of a management strategy, a 30-year-old who has diabetes might benefit from a combination of medicines designed to quickly lower blood glucose. A 70-year-old with diabetes might benefit especially from a plan that includes weight-bearing exercise, such as walking or strength training. These types of activity may simultaneously help with losing excess body weight and preserving bone density, which naturally declines with age.

To ensure that you’re following the best management plan for your diabetes, consult healthcare professionals you trust. Finding a capable care team that recognizes your distinct needs and helps you build a personalized plan is a critical first step toward improved wellness.

https://mcpress.mayoclinic.org/diabetes/type-2-diabetes-over-time-what-to-expect-as-you-age/

Type 2 diabetes monitoring: Blood sugar tests and health screenings

From mcpress.mayoclinic.org

If you have type 2 diabetes, measuring your blood sugar level, also called blood glucose level, is a useful way to track the status of your condition. But because high blood glucose can cause issues in your heart, kidneys, and even your eyes and feet, the best management strategies include additional tests to check for complications.

Keeping up with recommended testing and understanding test results empowers you to make informed decisions about your diabetes care. By working alongside your care team to refine your diabetes management plan, you can take steps to improve your health and happiness.

Blood sugar monitoring tests for type 2 diabetes

When you eat, your body breaks down the food into glucose, a type of sugar that fuels the cells throughout your body. The glucose enters your blood and gets into your cells with help from a naturally occurring hormone called insulin.

All types of diabetes stem from an issue in the interaction between blood glucose and insulin. If you have type 2 diabetes, your body doesn’t make enough insulin, can’t use insulin effectively or both. This causes glucose to build up in your blood. If your blood glucose level is too high too often, it can cause issues throughout your body.

There are a few methods for measuring your blood glucose level. Each serves a unique purpose. Using them together can create a clearer picture of your diabetes.

                                                                                                                   Getty Images

The A1C test measures blood sugar levels over time

The A1C blood test offers an overhead view of your average blood glucose level. “It’s a nice barometer for a three-month period,” explains Jessica R. Wilson, M.D., M.S., an endocrinologist and diabetes expert at Mayo Clinic in Jacksonville, Florida. The A1C test’s broad perspective is most useful for diagnosing diabetes and determining whether changes in your diabetes management plan, such as a new medicine or exercise routine, are affecting your condition.

The A1C test is sometimes called the glycated haemoglobin test. This is because the test doesn’t directly examine blood glucose levels. Instead, it measures what percentage of haemoglobin, a protein in your red blood cells, is coated with sugar in a process called glycation. The more glucose there is in your blood, the more haemoglobin gets glycated.

Any factor that influences your haemoglobin can interfere with A1C test accuracy. This can include having low iron, kidney disease, a low red blood cell count or a gene that influences the shape of your red blood cells.

If you have type 2 diabetes, the American Diabetes Association (ADA) recommends getting an A1C test at least twice every year. The best A1C test result to aim for depends on your age and diabetes history. An A1C result of less than 7% is a common goal for adults who have diabetes. If your A1C results are lower than this benchmark, “there’s a lower risk of eye damage, kidney damage, nerve damage and other complications,” Dr. Wilson says.

A blood glucose meter: A “snapshot” of blood sugar levels

While the A1C test is an important tool, people who have diabetes also need a quick way to check their current blood glucose levels. Using a blood glucose meter enables you to independently and accurately check your level within seconds. 

To use most blood glucose meters, you first insert a test strip into the device. Then you poke the side of a clean fingertip with a small needle, called a lancet, to release a drop of blood. When you touch the test strip to the blood, the meter shows your blood glucose level on a screen.

“The challenge is that doesn’t tell you how long it was at that level,” Dr. Wilson says. Everyone’s blood glucose levels naturally rise and fall throughout each day. Seeing a high or low result on a blood glucose meter could indicate that you took a snapshot during a natural swing. Or it could be evidence of a sustained issue. With a blood glucose meter, the only way to measure your level over time is to repeat the test throughout a certain period. This can be inconvenient and time-consuming.

Continuous glucose monitors track blood sugar throughout the day

Efforts to fill in the gap between the A1C test’s big picture and a blood glucose meter’s snapshot led to the development of the continuous glucose monitor. This device estimates the glucose level in the fluid between your cells, also called interstitial glucose, over time. The level of interstitial glucose is usually similar to the glucose level in your blood.

A continuous glucose monitor includes a tiny sensor inserted under your skin. The sensor transmits data to a receiver or your smartphone, which allows you to review your estimated glucose level minutes after the measurement was collected.

Automatically gathering a set of data points allows both you and your care team to build a clearer understanding of how your blood glucose changes throughout each day, Dr. Wilson says. Pairing a continuous glucose monitor with a log of day-to-day events — such as eating, taking a medicine or exercising — can help you optimize your diabetes management plan, especially if you’re using insulin therapy.

Like other glucose measuring tools, continuous glucose monitors aren’t always accurate. Compressing the sensor, which may happen while you’re sleeping, can cause the device to falsely indicate low blood glucose. Certain medicines also can affect readings.

Why is screening for type 2 diabetes complications important?

Measuring blood glucose is critical for tracking diabetes. But because type 2 diabetes can affect many parts of the body, testing for other health risks is just as crucial.

Dr. Wilson recommends that people who have type 2 diabetes start screening for complications as soon as they’re diagnosed — even though that may seem premature. “Most likely, there’s already been a period of time during which blood glucose was higher than the expected range,” Dr. Wilson says. Testing to detect any emerging issues can help you and your care team “get on the front end of it.”

The ADA’s current recommendations for people with type 2 diabetes include guidance for the following areas:

Heart and blood vessel health

People who have type 2 diabetes often have a higher risk of cardiovascular disease. The ADA recommends getting your blood pressure measured during every routine clinical visit, or at least once every six months. A lipid panel, which measures your cholesterol and triglycerides, is another important test for heart health. The ADA recommends getting a lipid panel when you’re diagnosed and at least once every year after.

Kidney health

Kidney disease also is common among people who have type 2 diabetes. The ADA recommends testing your urine albumin-creatinine ratio (uACR) and estimated glomerular filtration rate (eGFR) to check your kidney health at least once a year.

Nerve health and peripheral neuropathy

High blood glucose can cause nervous system issues. The ADA recommends an assessment for peripheral neuropathy by a healthcare professional after you’re diagnosed with type 2 diabetes and once every year after.

Eye and sight health

To monitor any vision issues, the ADA recommends having a dilated and comprehensive eye examination by an eye doctor after you’re diagnosed. Getting checked once every year helps your care team catch emerging issues.

Foot health

The ADA recommends an annual foot health examination. If you have a high risk of foot issues, a foot doctor might be able to offer specialized care.

https://mcpress.mayoclinic.org/diabetes/type-2-diabetes-monitoring-blood-sugar-tests-and-health-screenings/